Almost one in three children with disabilities in Russia lives in a violent environment in a state orphanage, a Human Rights Watch report says.

Many children live their entire lives in institutions, HRW says, where staff have been known to “beat them, inject them with sedatives, and send them off to psychiatric hospitals for days or weeks at a time to control or punish them.”

The 93-page report, "Abandoned by the State: Violence, Neglect, and Isolation for Children with Disabilities in Russian Orphanages," concludes that many orphanage children often lack access to health care, nutrition, and opportunities for play. Furthermore they receive little to no formal education.

HRW urged Russia to provide support for such children to live with their families or in other family settings rather than in institutions.

The Russian government has developed a plan to decrease the number of institutionalized children, but “it is not yet clear how and to what extent regional governments” have moved on the plan’s imperatives, according to HRW.

There are no solid figures on the number of orphans in Russia, but the Red Cross estimates it to be in the region of 600,000 – with up to 95 percent of these being “social orphans” with at least one parent alive.

HWR says health care workers pressure parents to give up their children to the system.

Child welfare campaigners told the BBC last year that ambitious plans to reduce the number of orphans were running into strong resistance from institutions that benefit from state funding. An orphanage gets about 1.5 million rubles ($40,000) from the government annually for each child it takes in, the BBC reported.

“This system is extremely profitable for the corrupted bureaucracy. That's why even the best practice in Russia experience of moving children to family care, is paralyzed and stopped by the system through the members of parliament," children's right campaigner Boris Altshuler said at the time.

HRW urged officials to devise a plan, with deadlines, to deinstitutionalize children.

“Until the Russian government and donors act, tens of thousands of Russian children may spend their lives between four walls, isolated from their families, communities, and peers, and denied the range of opportunities available to other children,” HRW researcher Andrea Mazzarino said.